You may have concerns about effects of giving birth on your pelvic floor, and about developing pelvic floor problems such as urinary or bowel incontinence.
Fortunately, you can influence most factors that affect the strength
and integrity of your pelvic floor. This Pregnancy Topic helps you
understand these factors and take steps in pregnancy, while giving
birth, and at other times in your life to help prevent pelvic floor dysfunction and promote good elimination, pelvic support, and sexual functioning.

Research has found that a number of childbirth procedures including some that are widely used can harm your pelvic floor. Your choice of caregiver, choice of birth setting, and decisions that you and your caregivers make impact your pelvic floor health.

One concept that is gaining ground is the idea that elective c-section (cesarean by choice) will prevent pelvic floor dysfunction by avoiding vaginal birth altogether. This approach involves many risks and questionable benefit; the topic is discussed in depth in

Informed
consent is a process to help you decide what will and will not be done
to you and your body, including whether you accept the care practices
noted above and others that may be offered to you. By law, you have a
right to the truth about benefits, risks and alternatives of care that
is offered to you (as best as it can be known at the time), to decide
what options are or are not in your best interest, and to accept or
refuse care. In the case of maternity care, informed consent also gives
you the authority to decide about care that affects your baby.

You
will want to talk over these issues with your care provider ahead of
time, of course. You should also know that few situations involving
interventions that can harm your pelvic floor will be emergencies. This
means you will almost always have time to learn about them in advance
and discuss them when they are proposed. (Learn more about informed consent.)

Planning
cesarean surgery simply to avoid the possibility of pelvic floor
problems is unlikely to be in your self-interest. Cesarean surgery
involves numerous extra risks to you and your baby. By contrast, the
likelihood of continuing to experience bothersome symptoms after the
postpartum recovery period with a vaginal birth is small. Moreover,
some women with continuing problems can obtain relief or cure and avoid
a corrective operation by an intensive regimen of pelvic floor exercises (kegels). It makes much better sense to avoid the procedures and practices that are known to cause problems in the first place.

The
best way to achieve this kind of birth is to choose a doctor or midwife
and a place to have your baby where those attending you agree with this
approach.

Good labor support is another important element. You and your partner may wish to arrange for a birth doula,
friend or relative to provide continous supportive care during labor.
Studies show that women who are accompanied in labor by non-medical
female companions trained or experienced in labor support are less
likely to have an epidural, an assisted vaginal birth, a cesarean, and
dissatisfaction with their labor experience.

Founded in 1918, Childbirth Connection has joined forces with and become a core program of the National Partnership for Women & Families. Together, these two women's health powerhouses are transforming maternity care in the United States.

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Childbirth Connection has joined forces with and become a core program of the National Partnership for Women & Families. Read more